| Christian Brothers University | |
|
650 E Parkway S Memphis TN 38104-5519 | |
| (972) 367-4845 | |
| Not Available |
| Full Name | Christian Brothers University |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 650 E Parkway S, Memphis, Tennessee |
| Authorized Official Name and Position | Mouzon Bass (ADMINISTRATOR/AGENT) |
| Authorized Official Contact | 9723674845 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Christian Brothers University 15305 Dallas Pkwy Ste 800 Addison TX 75001-6415 Ph: (972) 367-4845 | Christian Brothers University 650 E Parkway S Memphis TN 38104-5519 Ph: (972) 367-4845 |
| NPI Number | 1063161156 |
|---|---|
| Provider Enumeration Date | 03/23/2022 |
| Last Update Date | 03/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063161156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
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